Educate 420

Found this on my tumblr dash a few days ago.  I am reluctant to reblog or link to these sorts of posts without substantiating that what is being said is factually true.

From the New York Times:

http://www.nytimes.com/1999/04/14/us/mary-jane-rathbun-77-baker-known-for-marijuana-brownies.html

Here is an article from Leafly:

Vaporizing or “vaping” of cannabis has gained in popularity over the last several years, just as e-cigarettes have. But what exactly is vaporizing, and is it safe? We’ll help separate fact from fiction.

What Is Vaping?

Essentially, vaporizing is the heating of cannabis without burning. The heat releases the active ingredients into a vapor that is then released into the air in a fine mist created by a vaporizer device. Since combustion does not occur, smoke is not created.

Vaporizer products vary in size and functionality; this article will focus on desktop and portable flower vaporizers.

Is Vaping Safe?

According to two recent survey studies, people who vape cannabis perceive it to have health benefits and find it to be safer and less harmful to their health than smoking, Furthermore, cannabis vaporizers are specifically designed for inhalation without harmful smoke toxins.

But what do researchers say? Does vaporizing reduce ingestion of potentially harmful toxins like tar, ammonia, and carcinogens found in cannabis smoke? While there is very little research on cannabis vaporizing, studies over the years have shown that vaporizing does produce fewer carcinogenic compounds than smoking marijuana because it is heated but not combusted. Although cannabis smoke is less toxic than cigarette smoke, inhalation of any combustion product is less than desirable. Any type of smoke still contains gases and particulates that can create lung irritation and respiratory problems. In fact, over 100 toxins and compounds are released when cannabis is burned.

Smokers are more prone to respiratory infections and bronchitis, but it’s the smoke that gets you, not the cannabinoids. One of the first studies to compare smoking to vaporizing showed fewer respiratory affects with vaping, based on self-reporting of respiratory symptoms.

The Benefits of Cannabis Vaporization

Many medical patients have problematic respiratory systems and their lungs may be highly irritated by smoke, so they often find relief in vapor inhalation.

Some say vaporizers produce a more clear-headed high because smoke is not inhaled, but there are few studies that research whether vaping and smoking indeed create different types of highs. In an early study of 18 subjects, each subject either smoked or vaped one of three different strengths of THC (1.7, 3.4 of 6.8 percent), followed by measurements of delta-9-THC in blood and carbon monoxide in expired air. While blood levels were not significantly different, expired carbon monoxide was greatly reduced when vaporization was used.

In a recent 2014 study of about 100 subjects who both smoked and vaporized, consumers reported several advantages of vaporizing over smoking, including the lack of smoke smell and better taste. They also reported that the same amount of cannabis product produced more effect with vaping. After the study, nearly all participants planned to continue vaporizer use.

Novice consumers also tend to prefer vaporizing because the vapor can be inhaled in short puffs rather than deep breaths. Additionally, people appreciate the added benefit that it is more discreet to use a vaporizer.

Are There Disadvantages to Vaping?

The disadvantages reported have to do with the setup of the vaporizer, preparation of the cannabis (it must be ground into a fine consistency), waiting for the vaporizer to heat up, and the cleaning required after each use. In addition to a slightly more cumbersome process, many desktop and portable vaporizers are too expensive for casual consumers (although in the long run, vaporizers can save you money on cannabis).

A 2009 study was one of the first to look at variable temperatures and vaporizing. Like earlier studies, this 2009 study not only showed fewer harmful byproducts in vaping versus smoking, but also showed that temperature matters.

In this study, cannabis was vaporized at three different temperatures (338°F, 392°F, and 446°F), with the cannabinoid-to-byproduct ratio measured using high-performance liquid chromatography (HPLC). The ratio at 392°F and 446°F was significantly higher than in smoke, showing less harmful toxins when vaporizing.

Most vaporizers heat cannabis to a temperature just below combustion, in the range of 180 to 200°C (356 to 392°F). We now know that the amount of compound released does increase as its boiling point is approached. We also know specific temperatures at which various compounds are released: 220°F for THCA, all the way up to 428°F, right under the combustion temperature of 451°F, for the non-psychoactive compound cannabichromene (CBC).

Therefore, the elusive question regarding preferred vaporizer temperature can finally be answered. If for medicinal use, the temperature is dependent on the compound you need. Temperature for recreational use largely remains a personal preference.

Research on Cannabis Vaporization Ahead

Ten years ago, cannabis research had not occurred extensively because cannabis was illegal in most countries. As cannabis legalization and acceptance continues to spread across the United States and the world, more scientific studies are being conducted. An increase in information about vaporization and better availability of products is creating more appeal to cannabis users for both recreational and medicinal use.

Scientists are begging to study cannabis users to explore both the prevalence and perceptions of vaping, like in this survey of nearly 3,000 recreational cannabis users aged 18-90. Another study examines cannabis intake preferences in advanced cancer patients using cannabis to alleviate symptoms. There are more quantitative studies happening too, like this 2015 study that measured blood levels and confirmed earlier studies that vaporizing is an effective delivery route for THC.

Because more cannabis users are perceiving vaporizers as being less harmful while offering additional benefits, it’s more crucial than ever to encourage continued experimental research about vaporizing as a cannabis delivery method.

About the only thing that bothers me about this tutorial and other similar tutorials--there is zero explanation as to why you don’t need to decarb your cannabis as a separate, distinct step before soaking it in the butter.

Do the fats in butter and coconut oil activate the cannabinoids in the same way heat does from an oven or vaping device?

(1) Don’t use odor eliminators.  (2) Don’t smoke joints, blunts or spliffs--use pipes.  (3) Be mindful of smoke smell during and after.  (4) Use a “sploofy.”  (5) Ozium air sanitizer.  (6) Use a vaporizer.

Do’s

Do clean your bong daily, and your pipes once per week. “It really makes a difference; you can taste the smoke, not the resin,” says Berry, who also warns that water-based paraphernalia can grow mold or attract pests in a matter of days.

Do be mindful of the environment. Berry says his plant-based cleaner is safe to eat, and will not harm you or the environment.

Do protect new glass. “By adding 10 drops to the bong, resin will not stick to the glass,” says Berry of his product. “The resin actually prefers to stick to the cleaner. The next day, rinse it clean in hot water. Refill with 10 drops, add water and smoke again.”

Do discover the real flavor of your smoke through a clean pipe or bong. “That clean hit is the best,” says Berry.

Don’ts

Don’t use isopropyl alcohol. “Isopropyl alcohol…is by far the most commonly used cleaning substance for bong and pipe cleaning,” says Berry. “It is also listed by eight different government agencies as being toxic,” including the Environmental Protection Agency, Occupational Safety and Health Administration, and the International Agency for Research on Cancer.

Don’t experiment with anything you wouldn’t consume directly. Acetone-based nail polish remover, for instance, is hazardous. “You chose natural medication in cannabis, so why clean with hazardous chemicals?” says Berry.

Don’t spend too much time or money. Berry says using a cleaner like his costs less than eight cents per day, and should take less than a minute to wash away after each use.

I have been watching a lot of reviews for cannabis vaporizers and everyone of them has said you should use isopropyl alcohol to clean the various parts. :/

The extent of my cannabis experimentation so far has been limited to liquid tinctures and edibles.  I don’t have any firm plans on buying a vaporizer, but I am starting to warm up to the idea of having one.

Vaping is a fast and effective way to feel the effects of cannabis and is a lot cleaner than smoking.

From multiple sources I have heard good things about The Mighty.  It’s expensive and clunky, but I would be willing to overlook all that for the quality of the product.

The Alchemy vaporizer looks interesting, but I would want to know more about the product and company before making a purchase.

There are a lot of factors to consider when buying a vaporizer.

This is a pretty short article that gets to the point.

The suggestions generally make sense.  The suggestion I find the most interesting is the one about eating something sugary to increase your blood sugar levels.  

Is it common for high THC strains and / or Indica dominant strains to cause a significant drop in blood sugar, or does this only come into play if you consume too much? 

What to do?

Jann Gumbiner, Ph. D., writing for Psychology Today, sums up the research on alleged marijuana addiction, “About 10% of recreational users will develop problems serve [severe] enough to impair their work and relationships. Many more will come to depend on pot for relaxation and social purposes. This will be problematic if they don't learn more effective coping mechanisms and come to rely on marijuana instead of solving their problems. When ready, most people will be able to quit with only mild withdrawal symptoms.”

She emphasizes the psycho-social dependency, not any chemical dependency, and she notes users can quit easily with few withdrawal symptoms. So, cannabis smokers should take an occasional break.

Users call it a “Tolerance Break.” Because your system builds up a tolerance for favorite strains, the law of diminishing returns lowers your pleasure in the smoke over time. Taking a tolerance break refreshes your experience when you return to the strain or move on to another.

Since the 1980s, Miles Herkenham, Ph. D., has led benchmark studies in the neuropsychopharmacology of cannabis use for the National Institute of Mental Health. His rats’ lab experience shows that THC tolerance depends on time and dose and that breaks can reverse it.

For how long?

Your body type, age, weight, and so on decide how long to take your break. You want to get the THC out of your system until you don’t feel the craving. Different weed forums suggest 48 to 72 hours or one to two weeks.

The T-break will cost you some adverse reaction, so it might take more than you expect. But, you should set a target. For example, if you smoke regularly, you will suffer the same problems any tobacco smoker would endure on giving up cigarettes: restlessness, poor sleep, appetite change, and irritability.

You can beat the stress with aerobic exercise, sex, nutritional supplements, ample hydration, and work. If you do things you enjoy, you’ll increase your tolerance for those good times as well.

Hmmm....  Not the first time I have heard about this. 

In order from beginning to end the article lists: white out / blood sugar drop, shakiness / tremors, cotton mouth, paranoia and psychosis.

Anyone who has looked at cannabis strains on Leafly should know that a lot of strains pose some risk of inducing paranoia, anxiety, dry mouth, nausea and headaches.

This is the first time I have heard that cannabis use can cause a significant drop in blood sugar leading to dizziness, weakness and unconsciousness.

A lot of what I have been reading about cannabis focuses on the CBD to THC ratio with little to no attention to how terpenes can enhance the effects of a given strain (too little information).

As for decarboxylation, I am finding a lot of information, but the information either conflicts and / or doesn’t provide enough elaboration. “You should decarb this way if your goal is ____ if your end goal is _____ this way is better because _____.  Using tin foil is preferable / not preferable because ____.” (too much information without clarification).

Remember when you were a kid and you had to sit through a block of D.A.R.E. (that's Drug Abuse Resistance Education for the non-alumni) assemblies to learn how the world is full of dangerous drug peddlers waiting to ambush you at every corner so they can shove a wad of pills, needles, and marijuana down your throat and get you hooked for life? And remember reading about how the D.A.R.E. program has had "no statistically significant long-term effect on preventing youth illicit drug use"? Do you recall hearing about how D.A.R.E. received a $13.7 million grant to create a new curriculum that would be more effective in preventing drug use among minors?

Well, clearly the "new" D.A.R.E. program that's focused on "keepin' it REAL" is smarter, more modern, and more reasonable than the D.A.R.E. lessons us twenty and thirty-somethings recall being subjected to in elementary school. Instead of rehearsing "just say no" skits and learning corny rap songs about how "drug-free is the way to be!", today's D.A.R.E. kids have stepped firmly into the 21st century and are learning that "for every one joint of marijuana, four teenagers become burdened with pregnancy," according to a news story that was posted on the program's website. They're keepin' it real, all right — here in Washington we're up to our eyeballs in pregnant teenagers thanks to the state's legal retail cannabis market. We have to plow the streets every morning, we've got so many.

I'm kidding, obviously — anyone with a modicum of common sense would realize that smoking a cannabis joint doesn't automatically fertilize the eggs of four teenage girls within a five mile radius. D.A.R.E., unfortunately, didn't really think that claim through, nor did they apply any critical oversight to these other ludicrous anti-drug gems from the article:

"Marijuana candies, sold on the street as 'Uncle Tweety's Chewy Flipper' and 'Gummy Satans' are taking the country by storm."

"It is sad that in a country as developed as America, such third world drugs such as marijuana are allowed to exist."

"Children are being addicted to marijuana. I knew this day would come, when a liberal president allowed a state to legally sell Marijuana Flintstone vitamins to children."

"Marijuana. It is one of the most dangerous drugs on Earth."

Before your outrage threatens to burst through your skin, creating a supernova of wrath that blots out the sun, the article that D.A.R.E. published on its website was repurposed in its entirety from topekasnews.com, a satire news site. If you were rolling your eyes at how ludicrous the above bullet points sounded, that's because they were intentionally written to sound as absurd as possible. Unfortunately, the content wizards over at the D.A.R.E. organization didn't identify the article as fake, nor did they bother to research the legitimacy of the source from where they were repurposing the article.

Instead, D.A.R.E. blindly published an article making ridiculous, politically-charged claims with the intent of spreading the misinformation under the guise of drug prevention and education. No wonder the D.A.R.E. program has been labeled ineffective — how can you take an anti-drug program seriously when it peddles nonsense, outright lies, and can't even fact-check the sources it's citing?

We can all agree that children need to learn how to stay away from drugs and how to say no to peer pressure that's encouraging them to do something they're not comfortable with or don't want to do. But spreading fear and misinformation in order to promote your agenda does not pave a path towards healthy and informed decision-making, it cultivates a culture of ignorance, cynicism, and stagnation. We need drug awareness programs that reasonably inform, not blindly terrify.

The D.A.R.E. website deleted the article as soon as a Washington Post writer informed the program that it was fake, but the damage had already been done. Once again, the anti-drug program has been reduced to a punchline instead of an effective tool to educate kids on responsible behavior, informed decision-making, and self esteem-building. As with scrunchies, No Fear shirts, and CK1 cologne, perhaps it's time to tuck the D.A.R.E. program away with other embarrassingly dated 80's and 90's trends and replace it with something that reasonably reflects the changing cannabis landscape and takes a modern, positive approach to educating children.    

It’s been a while since I was in middle school / high school, but I suspect much has not changed. 

Simply telling kids, “don’t do drugs“ and listing the bad things that can happen is not enough. 

It’s not all that different from Abstinence Only sex education.  It’s not comprehensive enough. 

What do you do when you decide you actually want to have sex?  It doesn’t teach you how to minimize the risk of pregnancy, sexually transmitted infections, how to tell if you may be in an abusive relationship, that only an enthusiastic yes means yes and an overview of the diversity of human sexuality and sexual orientation (among other things).

Telling emotional stories about how someone’s life was ruined by alcohol or drugs have there place, but it’s not the whole story.  Some people die, leaving behind grieving friends and family, sometimes a single lapse in judgement changes everything, some are able to use drugs and be functional members of society, some people just use drugs every now and then and it’s not a big deal.

Instead of the message being, “don’t do drugs” it should be something more nuanced: “As a young person your body and brain are still developing, heavy, prolonged drug use can have negative effects.  There is a lot that remains unknown about long term effects of certain drugs.  Some drugs are more harmful than others.  Using drugs by yourself or in a social setting carry different risks.  If you are currently using drugs or ever plan to use drugs here are some ways to minimize potential harm and stay safe...”

For example:

- How to respond if you or someone you know is having a bad reaction and or OD-ed.

- Which drugs are the most dangerous via rates of death, addiction and negative impact on the body.

- .If you are using drugs as a coping mechanism, here are some resources and suggestions.

- If you are going to a party with alcohol and drugs.  Keep an eye on your drink at all times

[...]

In the past few months, consumers in Colorado have been perplexed by a seemingly nonstop series of health and safety recalls, prompted by the discovery of pesticide residue in cannabis products ranging from flower to concentrates to edibles. In Washington state, consumers remained untroubled by the Colorado news, as their state-regulated industry seemed immune to pesticide recalls. What the industry knew — and most consumers didn’t — was that the lack of recalls didn’t equate to a clean bill of health. It mostly just meant the state wasn’t testing cannabis products for pesticides.

[...]

Now the truth is becoming more widely known. Far too many pesticide-tainted products are reaching the shelves in nearly all medical and recreational states. Cannabis consumers have a lot of questions. We’ll try to answer a few of them.

Will the pesticide residue on my cannabis make it into my bloodstream?

Yes. Simple answer. We have solid research on this, thanks mostly to Jeff Raber, founder of the Werc Shop cannabis analytic lab in Pasadena, Calif. Over the past few years Raber has been testing cannabis products and publishing the results in peer-reviewed scientific journals. Three years ago Nicholas Sullivan partnered with Raber and the Werc Shop’s Syzte Elzinga on a study of pesticide residues in cannabis smoke. They contaminated batches of flower with four common pesticides — diazinon, paclobutrazol, bifenthrin, and permethrin — and then measured how much came through in the mainstream smoke of two common smoking vehicle, a glass pipe and a bong. With a glass pipe, smokers inhaled about 65 percent of the pesticide on the leaf. Using a bong they took in about 50 percent of the pesticide. That transfers to the blood via the alveoli in the lungs.

In general, Sullivan, Raber, and Elzinga wrote in the Journal of Toxicology, “the portion of pesticide recovery is alarmingly high and is a serious concern.”

It’s especially concerning to medical patients using cannabis. Pesticide residue, they wrote, “can pose substantial threats to immuno-compromised patients or patients with other conditions, such as diseases of the liver, that may intensify the toxicological effects of pesticide exposure.”

Why are concentrates a bigger problem than flower?

Because the processes used to concentrate cannabinoids also concentrate pesticides. The Cannabis Safety Institute’s 2015 study found roughly ten times the level of pesticides in concentrates as in flower, which was surprising given that cannabinoids are only two to five times more concentrated. There are a number of possible explanations for this. Extraction techniques may more efficiently concentrate pesticides; chronic contamination of extraction equipment may lead to cross-contamination; or the trim from which concentrates are made may be more heavily contaminated than the flower sold separately. In any event, the CSI white paper, produced by the Oregon labs OG Analytical and Phylos Bioscience, is highly recommended reading: clear, brief, helpful.

How toxic is “toxic”?

Great question. Nobody knows with enough specificity to say, “If you inhale X amount of diazinon, it will harm your liver exactly in this way.” The science of pesticide toxicity is a rabbit hole of difficult data, apples-to-oranges comparisons, variable types of toxicity (acute vs. chronic), and differing definitions of risk. Paclobutrazol, for instance, isn’t FDA-approved for use on food crops. But it is approved for certain food crops by the European Union. (If you want to know more about paclo, here’s a good place to start.)

In Seattle, the King County Public Health Department issued an advisory about pesticides and cannabis last fall. They wrote: “Because marijuana is often smoked or vaped and little is known about the effects of inhaled pesticides, it is important to learn more about the health effects of pesticide exposure both through inhalation (smoking) as well as through ingestion of marijuana products.”

In other words: Science doesn’t know much about inhaled pesticides, so it’s important to learn more about inhaling pesticides. Which science doesn’t know much about.

[...]

Did pesticide residue become a problem just recently?

No. It became known recently. We’ve been inhaling and eating this stuff for years. Seven years ago, for example, the Los Angeles city attorney’s office acquired and tested three medical cannabis samples from local dispensaries. Two of the three samples were contaminated with exceedingly high levels of bifenthrin, a common pesticide that’s enormously toxic to bees but not so much to humans. Bifenthrin is relatively low on the risk scale, but one cannabis flower sampled by the L.A. city attorney contained 1,600 times the legal amount deemed safe for human consumption.

Last fall, Ricardo Baca and David Migoya of the Denver Post revealed that state regulators in Colorado knew as early as 2012 that cannabis was being grown with potentially dangerous pesticides. But with the EPA refusing to offer guidance (because cannabis is federally illegal), and growers opposing most restrictions, the Colorado Department of Agriculture made cannabis pesticide inspections a low priority.

[...]

How and where can I find pesticide-free products?

You must demand them. Ask your bud tender if a specific product has been tested for pesticides. Ask which lab did the testing. If you’re concerned about pesticide residue, make it clear to your retailer that you are willing to pay more for clean product. Testing isn’t cheap. Growing organically isn’t easy. If customers want nothing but the cheapest, most potent products, that’s where the industry will go. If customers demand higher quality, pesticide-free flower, concentrates, and edibles, producers and retailers will react accordingly. Your money talks.

I am not finding a date for this article. The comments on the article so far go back 4 and 9 months.

Video description:

CNN's award-winning chief medical correspondent Dr. Sanjay Gupta, a chief neurosurgeon, puts medical marijuana under the microscope. All three (3) of CNN's current "Weed" documentaries compiled into one video.

The United States is in the midst of an opiate epidemic. All around the country, in every city, in every state, hundreds of thousands of Americans find themselves somewhere on the perilous path of opiate addiction. Tens of thousands of overdoses tear families apart each year and in some communities it’s a daily occurrence. Whether it’s pills or heroin billions of dollars exchanges hands in the illegal drug market and no small part of that fortune is made in the illicit opiate trade. Yet despite all of that, Attorney General Jeff Sessions continues to liken marijuana use to heroin use and continues to push for a crackdown on both recreational and medicinal cannabis; which would be a sink of very valuable resources in a time where they are clearly needed elsewhere.

Jeff Sessions has a long history of comparing marijuana to harder drugs, but amid the largest opiate epidemic the country has ever seen the attorney general continues to claim it has the same impact as heroin. The top law enforcement official in the United States consistently makes the baseless claim that marijuana is on the same level as heroin when it comes to negative impact on society.

Yet in the four states that have legalized things seem to be going just fine. With the exception of the occasional edible trip turned bad from someone new to the drug, there don’t seem to be many obvious widespread downsides to legalization. Nobody has ever died from marijuana overdose. Rates of teenage use are down in Colorado, drugged driving incidents haven’t spiked significantly, and the economies of these states are experiencing the benefits of a new found billion dollar industry.

Yet Jeff Sessions reportedly asked President Donald Trump for permission to go after medical marijuana dispensaries and the situation on the ground seems to indicate that president Trump didn’t object.

Recently in Detroit local law enforcement in tandem with national officials shut down 167 dispensaries. While many of these were operating outside the confines of Michigan state law, and certainly federal law, it still seems like a gross misallocation of resources. Especially considering the difficulty many communities in the upper Midwest are experiencing when it comes to coping with the current opiate crisis.

Drug overdoses are now the leading cause of death for people under the age of 50 and the current crisis has impacted states like Michigan particularly hard. Opiate deaths increased by 15% since 2015, which was a record year to begin with as the United States saw over 52,000 overdose deaths in 2015. To put that in perspective in 1990 just over 8,000 people died from opiate overdose. Now more people die from opiate overdoses than people died of car crashes, HIV, and gun crime, in their respective peaks. Tens of thousands of people are overdosing every year and the Trump DOJ is focused on medical marijuana dispensaries.

If there was a plan for a broad increase in police activity, focused on cracking down on all forms of illicit drug use, and offering meaningful treatment or rehabilitation, that would be one thing. Instead the Trump administration has cut back on important treatment programs and funding for large swaths of American addiction treatment infrastructure. This has been coupled with a doubling down on failed police tactics as evidenced by the Detroit shut down and various statements from the DOJ likening legal marijuana to harder drugs such as heroin.

Which is a joke, an incredibly bad and dangerous joke that anyone who takes a few minutes to look the reality of the opiate crisis will see right though.

Cannabis can make people feel more relaxed, less stressed, and, of course, happier. So predictably, people experiencing depression or anxiety are much more likely to use cannabis — and more of it — than people not suffering from these conditions.

Of course, many people with these conditions also take prescription antidepressants. Consequently, it’s important for medical professionals and patients to be educated on potential interactions that could arise by combining the two.

Remarkably, despite years of research investigating links between cannabis use and psychiatric disorders, few rigorous studies have been published that closely examine how cannabis and antidepressants may interact.

[...]

The University of Connecticut researchers explain why there may be so few reports: it’s possible adverse events are “relatively rare” or “do not happen.” Moreover, “newer psychotropic medications have a relatively high therapeutic index” — as a class of drugs, they are less likely to produce adverse interactions. However, they also noted that lack of recognition or awareness could be to blame, and patients experiencing adverse effects may resist disclosing their cannabis use for fear of stigmatization.

Nonetheless, it’s likely that newer antidepressants carry a low to moderate risk for interactions, while older antidepressants carry a higher risk. Characterizing the risk as “moderate,” RxList, an online index of drugs published by WebMD, advises patients who use cannabis to “be cautious” and “talk with [their] health provider.”

One of the challenges facing physicians prescribing antidepressants to patients who also use cannabis (or any other substance, for that matter) is that it makes it more difficult to prescribe the most appropriate drug at the right dose, and co-occurring cannabis use can impede their ability to accurately assess efficacy of prescribed drugs. 

[...]

Cannabis users who are considering a new prescription drug to treat depression or anxiety may want to consider — at least temporarily — abstaining from use and allowing the antidepressants to take effect. Allan Schwartz, LCSW, Ph.D. a psychotherapist and licensed clinical social worker in Colorado and New York, has found that (particularly in severe cases) patients should abstain from cannabis and other substances during treatment. “I was, at times, able to get patients to agree to stop their marijuana use for a few weeks just so they could determine whether there was or was not an improvement in mood,” says Schwartz. “These individuals were surprised, but were willing to admit that they felt real improvement in mood and functioning.” 

[...]

Anecdotally, many physicians report that some patients who use cannabis, alcohol, or other drugs during treatment — particularly those with severe depression or bipolar disorder — are less likely to adhere to their treatment protocols, including prescription drugs and behavioral interventions (e.g. cognitive behavioral therapy, psychotherapy, etc.).

Schwartz says he has seen patients go on and off their medications, often with disastrous results. “I have directly witnessed the tragedy of patients going off of their medications for bipolar disorder, using marijuana and ending up re-hospitalized in worse shape than any time prior to the relapse,” claims Schwartz. “In fact, it has been my experience that many of these unfortunate patients experienced multiple relapses and were caught in an endless cycle of hospitalizations marked by periods of instability in between.”

Beyond these generalized risks, each class of antidepressants is unique and associated with varying side effects and potential interactions.

[...]

Finally, patients should keep in mind that while there is evidence that low doses of THC can produce desirable effects (such as euphoria and relaxation), high doses can do the opposite — too much THC can increase anxiety (or even induce a panic attack). The second most prominent cannabinoid in cannabis, CBD, counteracts many of the adverse effects of THC, and significant preliminary evidence suggests CBD may be useful to combat anxiety, depression, and other psychiatric disorders. Therefore, if you’re experiencing anxiety or depression and choose to use cannabis, seek out strains that are high in CBD.

Can you overdose on cannabis? No. The number of people who have died due to cannabis overdose, in all of recorded history, is zero.

That’s one of the most well-known facts in the cannabis library. But is it really true? And if so, why?

Yes, it’s true. Cannabis itself cannot kill the human body. But let’s be clear: It is very possible to “overdose” on cannabis in the sense of overconsumption.

[...]

Why is that, exactly?

It’s possible to die from opioid overdose or alcohol poisoning. But cannabis acts on the body and mind in a way that’s very different than opioids or alcohol.

We’re all familiar with the tragic phrase “died of an overdose,” but when opioids like fentanyl, Oxycontin, or heroin are the cause, there’s a specific mechanism that leads to death. As Oxford University anesthesiology professor K.T.S. Pattinson has observed, “In drug addicts, respiratory depression is the major cause of death.” In other words, during an opioid overdose the victim falls unconscious and the body forgets to breathe.

[...]

In some cases, an opioid overdose can also depress the brain’s mechanism that regulates the heart and blood circulation, leading to a drop in blood pressure and heart failure. Alcohol poisoning can become lethal when the alcohol overwhelms the liver’s ability to clear it, and alcohol in the blood anesthetizes those same brain systems that regulate breathing and blood pressure. They shut down, which leads to death.

Why doesn’t cannabis have the same effect? Because cannabinoids act on specific receptors that are not concentrated in the brainstem, where breathing and heart rate are controlled.

Cannabinoid receptors are most highly concentrated in the basal ganglia, the hippocampus, and cerebellum, which control cognition and movement. Those same receptors appear in scant numbers in brainstem areas like the pre-Bötzinger complex.

[...]

To summarize, opioid and alcohol overdose can shut down the body’s breathing and blood circulatory systems that are located in the lower brain stem. Cannabis does not have the ability to affect those lower brain stem systems in the same way. While it is very possible to overdo your cannabis intake, it’s not possible to die from a cannabis overdose.